Long-term clinical remission maintained after cessation of zidovudine and interferon-α therapy in chronic adult T-cell leukemia/lymphoma

Lucy B. Cook, Aileen G. Rowan, Maria A. Demontis, Sophie Sagawe, Nicolas A. Gillet, Anat Melamed, Claire Greiller, Aviva Witkover, Charles R.M. Bangham, Graham P. Taylor

Research output: Contribution to journalArticle

Abstract

© 2017 The Japanese Society of Hematology Globally, > 5–10 million people are estimated to be infected with Human T-lymphotropic virus type 1 (HTLV-1), of whom ~ 5% develop adult T-cell leukemia/lymphoma (ATL). Despite advances in chemotherapy, overall survival (OS) has not improved in the 35 years since HTLV-1 was first described. In Europe/USA, combination treatment with zidovudine and interferon-α (ZDV/IFN-α) has substantially changed the management of patients with the leukemic subtypes of ATL (acute or unfavorable chronic ATL) and is under clinical trial evaluation in Japan. However, there is only a single published report of long-term clinical remission on discontinuing ZDV/IFN-α therapy and the optimal duration of treatment is unknown. Anecdotal cases where therapy is discontinued due to side effects or compliance have been associated with rapid disease relapse, and it has been widely accepted that the majority of patients will require life-long therapy. The development of molecular methods to quantify minimal residual disease is essential to potentially guide therapy for individual patients. Here, for the first time, we report molecular evidence that supports long-term clinical remission in a patient who was previously treated with ZDV/IFN-α for 5 years, and who has now been off all therapy for over 6 years.
Original languageEnglish
Pages (from-to)378-382
Number of pages5
JournalInternational Journal of Hematology
Volume107
Issue number3
DOIs
Publication statusPublished - 1 Mar 2018

Keywords

  • Chronic ATL
  • HTLV
  • Zidovudine/interferon-α

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    Cook, L. B., Rowan, A. G., Demontis, M. A., Sagawe, S., Gillet, N. A., Melamed, A., Greiller, C., Witkover, A., Bangham, C. R. M., & Taylor, G. P. (2018). Long-term clinical remission maintained after cessation of zidovudine and interferon-α therapy in chronic adult T-cell leukemia/lymphoma. International Journal of Hematology, 107(3), 378-382. https://doi.org/10.1007/s12185-017-2361-7